[Skin contact method, breast feeding, nursing. Experiences of a nurse counselor].
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Breast Feeding↗
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Two different methods for feeding low birth weight babies.
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Energy Metabolism↗
A simple method of feeding jejunostomy tube placement.
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Enteral Nutrition↗
[Breast feeding: which contraceptive method?].
Contraception during breast feeding must take two points into account: the first physiological contraception due to anovulation which disappears at around the 9th week of lactation); the second pharmacological: any substance ingested by the mother during breast feeding is excreted in milk, chiefly by passive diffusion. All pharmacokinetic studies have shown that the transfer of progesterone or of estrogen when taking a contraceptive pill is extremely slight, being of the same order as that of natural hormones. When it is decided to use hormonal contraception, this should be started after the 6th week of lactation, when lipid profile has returned to normal and thromboembolic risk is identical to that of the population in general. As with all prescription during lactation, the drug should be taken as far as possible from the next feed. Barrier techniques (combining condoms and spermicides) are an elegant alternative to drug methods.
Amenorrhea↗
Modulation of rotavirus enteritis during breast-feeding. Implications on alterations in the intestinal bacterial flora.
A cohort of 197 infants was followed up prospectively for a single rotavirus (RV) season, 1983 to 1984, to examine the effect of long-term feeding method on RV infection. The feeding classification distinguished breast vs formula milk intake over the long term, for at least 18 weeks from birth (approximately four months). During the follow-up period, relative numbers of RV particles in feces were compared by electron microscopy, and positive specimens were confirmed by an enzyme-linked immunosorbent assay. There was no apparent difference in the infection rates of rotavirus enteritis in breast-fed (20%) as compared with bottle-fed (17%) infants. However, clinical manifestation of illness was milder in breast-fed infants. Among the breast-fed subjects, fecal flora identified by bacterial cultures, biochemical reaction, and gas-liquid chromatography revealed a significant growth of bifidobacteria lasting as long as the period of lactation. Colonization by this organism above the detection level of log 10(5)/mL was not observed in the feces of bottle-fed infants. These data suggest that alterations in enteric flora induced by breast-feeding may be correlates of intraluminal events, mediated by human milk, that modulate the clinical course of RV gastroenteritis.
Bifidobacterium↗
Complex II inactivation is lethal in the nematode Caenorhabditis elegans.
RNA-mediated interference (RNAi) was employed to systematically inactivate the four subunits of complex II in the mitochondrial electron transport chain. Embryonic lethality was the predominant result of inactivating three subunits (ceSDHB, ceSDHC, and ceSDHD) when using the soaking method to inactivate RNA. The feeding method was employed to deliver dsRNA from the fourth subunit (ceSDHA) to wild-type, mev-1 (mutated in ceSDHC of complex II), and gas-1 animals (mutated in a complex I gene). Survival was reduced only in the mev-1 genetic background, and in an oxygen-dependent fashion. Collectively, these data provide further evidence that compromised complex II integrity can result in sensitivity to oxidative stress.
Journal Article↗
Trials to infect Anopheles stephensi with Plasmodium yoelii nigeriensis by the membrane feeding technique.
The aim of this study was to find optimal conditions for the membrane feeding technique to obtain maximum infection rates of mosquitoes with Plasmodium yoelii nigeriensis. The results show that the malaria parasite Plasmodium yoelii nigeriensis is most infective to Anopheles stephensi mosquitoes on day 3 of the infection in the mice, 1 day before the peak of parasitaemia. The mortality rate of the mosquitoes fed on mice on day 3 after infection was the highest as compared to mosquitoes fed on other days after infection. Gametocytes from mice 3 days after infection were fed to mosquitoes by three different membrane feeding methods. The results indicate that feeding during the first 10 min after blood collection gave the highest infection rates. Keeping the blood meal at a pH of 7.2 yields higher infection rates than keeping it at pH of 8.5. Stirring of the blood and supplying it with CO2 is not necessary when feeding of the mosquitoes is completed within the first 10 min after collection of the blood.
Animals↗
Evidence-based feeding guidelines for very low-birth-weight infants.
Clinical practice guidelines (CPG) for the nutritional management of premature infants are limited. This project focused on the development of a research-based enteral feeding CPG for infants of < 1,500 g. The CPG was based on an extensive literature review and developed through a process of consensus decision making by a team of clinical researchers. Infants that weigh < 1,000 g initiate minimal enteral nutrition (MEN) at 48 hours; nutritional feedings begin on day 5 to 6 of life. For infants between 1,000 and 1,500 g, nutritional feedings begin at 48 hours and are advanced at a rate of less than 30 mL/kg per day. The benefits and risks of continuous versus intermittent nasogastric tube feeding were inconclusive; therefore, the CPG does not stipulate a feeding method. Breast milk is used preferentially, and specific guidelines for the definition and management of feeding intolerance are provided. A follow-up study testing this CPG has been completed and is published in the original research section of this issue.
Consensus↗
Culicoides arakawae (Diptera: Ceratopogonidae) efficiently blood-fed and infected with Leucocytozoon caulleryi through a natural membrane.
Culicoides arakawae, the most common Culicoides sp. on chicken farms in East Asia, is an important blood-sucking insect and Leucocytozoon caulleryi vector. How parasites, in an ingested blood bolus, enter the midgut of insects and deal with this complex and biochemically hostile environment is poorly understood. However, successful blood-feeding through a membrane in C. arakawae is beneficial for studying this phenomenon. Therefore, a membrane-feeding method for C. arakawae was developed in. The blood-feeding success rates of C. arakawae fed through five different membranes were: turkey egg at 43.7+/-11.7%, chicken egg at 45.2+/-12.1%, duck egg at 38.8+/-12.0%, pig gut at 0% and chick skin at 0%. In fertility measurements, the average number of eggs produced for C. arakawae fed through egg-shell membrane, at 77.7+/-15.1 per female, was significantly higher (P<0.01) than the 46.7+/-10.6 found in C. arakawae fed on the breast skin of a live chicken. Meanwhile, in parasite infectivity tests, C. arakawae could be infected by L. caulleryi when the vector was blood-fed with infective blood cells reconstituted with specific pathogen-free (SPF) sera through an egg-shell membrane. The sporozoite average and infection rates of inoculated chicks were 166.8+/-12.5 and 100%, respectively. In conclusion, feeding C. arakawae blood through fowl-egg-shell membranes should be an efficient method for in vitro infection of midges as the engorged midges are infected by parasites and display reproductive potential. Furthermore, the method is practical for feeding a large number of midges.
Animals↗
Establishing breast feeding in hospital.
The experience and practice of the author is described in her appointment as a breast feeding advisor to the paediatric and obstetric units at University College Hospital with special responsibility for supervising infant feeding, especially breast feeding in the maternity unit. During 1980-5 there were 13,185 mothers whose babies fed. The feeding method of 12,842 mothers was recorded on discharge from the postnatal wards and 77% were breast feeding; only 3% of these mothers gave complement feeds of infant formula. The practices in the maternity wards to enable mothers to establish successful breast feeding and the methods of dealing with common problems of breast feeding are described.
Breast Diseases↗
Human milk pumping rates of mothers of singletons and mothers of multiples.
Rates of breastfeeding are increasing, but the methods by which human milk is fed to infants is not well described. Using a retrospective survey design, the authors collected information about infant feeding from mothers of term, preterm, singleton, and multiple-gestation infants (n=346). Human milk feeding methods were characterized as solely at the breast, pumped only, or a combination. Sixty-eight percent of mothers in the study fed their infants at least some human milk; 77% of these mothers reported pumping milk. There was no difference in the percentage of pumping based on multiple gestation or length of pregnancy. Feeding human milk solely at the breast at early postpartum time points was associated with longer durations of human milk feeding overall. More research is needed to better understand why mothers choose pumping over direct human milk feedings and to evaluate the health outcomes associated with this practice.
Adult↗
The epidemiology of acute diarrhoea in a rural community in Imo State, Nigeria.
As part of an evaluation of a water supply and sanitation project, a baseline cross-sectional study of diarrhoea, and its putative risk factors, was conducted in 5 villages in Imo State, Nigeria. Data were collected from 4641 and 5920 persons during surveys in the dry and wet seasons, respectively. 8 d period prevalence rates for diarrhoea ranged from 5 to 50%, with the highest rates occurring in the 6 to 23 month age group. Diarrhoea was associated with up to 75% of all illnesses in young children and with about 20% in adults. Risk factors included lower socio-economic status, an unclean domestic environment, use of non-purified water, absence of soap, and feeding methods other than exclusive breast-feeding in the early months of infancy. These results suggest that the education component of water supply and sanitation projects should emphasize personal and domestic hygiene and infant feeding.
Adolescent↗
[Factors influencing the choice of breast feeding by mothers. Results of a survey at public maternity hospitals].
A questionnaire survey was carried out in a public maternity hospital among 350 mothers who had just given birth, in order to study factors possibly influencing their choice between breast feeding and bottle feeding. The high rate of questionnaire response (96%) indicated that mothers were much concerned by this choice. According to the feeding method initially chosen (breast, mixed, bottle feeding) 3 groups of mothers were distinguished and were compared by chi 2 analysis. The results showed specific characteristics within each group, such as the definite nature of the decision regarding bottle feeding, and trend-indicators for the choice of feeding, such as the events during pregnancy and delivery, parity, standard of education, reaction to separation from the baby at birth and the number of birth-preparation courses followed. Relatives and the medical team appeared to have no influence on mother's decisions and interest in freedom of choice remained constant. These results are indicative in determining actions for the promotion of breast-feeding, some of which have been proposed in this study.
Bottle Feeding↗
Feeding and the development of enteroinsular hormone secretion in the preterm infant: effects of continuous gastric infusions of human milk compared with intermittent boluses.
Preterm infants receive gastric milk feeds as continuous infusions or intermittent boluses. It is not known whether these feeding methods have different effects on the development of digestive metabolism. We have measured plasma levels of insulin, pancreatic polypeptide (PP), gastric inhibitory polypeptide (GIP), gastrin, motilin, enteroglucagon (EG) and neurotensin (NT) in 19 preterm infants (28-34 weeks gestation) tolerating full enteral feeding from birth. 7 infants received human milk by continuous infusion, 12 infants were bolus fed. Hormones were measured in cord blood and at 6 and 13 days of age; samples were drawn preprandially in bolus fed infants. Both groups showed similar significant increases in plasma motilin, PP, NT and EG levels. At 13 days infusion fed infants had higher insulin. GIP and gastrin levels. No difference in rate of weight gain was seen in the two groups of infants. We conclude that both methods of feeding induce progressive changes in circulating enteroinsular hormone levels. However, the endocrine milieu is different in the two groups, particularly since bolus-fed infants experience marked cyclical surges in hormones after boluses of milk by 13 days of age. These differences in hormone release may affect metabolic homeostasis.
Enteral Nutrition↗
Assessment of growth and feeding practices in children with cleft lip and palate.
Feeding difficulties in cleft lip and palate (CLP) infants is commonly observed and is the most traumatic experience the family has to face. These infants are undernourished and have compromised growth. The purpose of this study was to 1) assess general health and growth parameters in children with CLP and in normal children; and 2) investigate the feeding methods of CLP infants and normal infants. A total of 221 children from birth to six years of both sexes, with CLP (60 children) and normal (161 children) were selected. The CLP and normal children were divided into three subgroups by age. The practice of feeding the infants in subgroup I was assessed using standard piloted questionnaires. The assessment of growth was done at baseline and at six months in all the subgroups.The general well being of the children was assessed by noting the number of common infections. Results showed that a significantly higher percentage of mothers with normal babies (p < 0.01) had a positive attitude towards breast feeding. When compared to normal children, CLP children were more susceptible to infections (p < 0.05) and measured significantly lower on the height growth curve(p < 0.05). Hence, height can be used to monitor growth in CLP children.
Body Height↗
Counsellors' perspectives on antenatal HIV testing and infant feeding dilemmas facing women with HIV in northern Tanzania.
This study investigated the infant feeding advice that counsellors were giving HIV-infected pregnant women in Moshi, Tanzania, the factors they thought had an impact on women's infant feeding choices and their role in influencing these decisions. The data are drawn from in-depth interviews with 16 nurses working as counsellors in their spare time in an antenatal trial of prevention of mother-to-child transmission, five local HIV/AIDS counsellors and two medical doctors, whose counselling experience ranged from less than six months to nine years. Informed choice of infant feeding method by HIV-infected women, as recommended by UNAIDS/WHO/UNICEF Guidelines, was seriously compromised by the actual advice given, directive counselling, lack of time to cope with a positive HIV test result, and lack of follow-up support, regardless of socio-economic status. Infant feeding options were not always accurately explained, but counsellors believed most women had little choice but to breastfeed and were unlikely to exclusively breastfeed, despite advice. It was apparent that the risks and benefits of the options open to HIV-infected women were complicated for the counsellors, not only the women. Counsellors needed additional training in non-directive counselling and infant feeding options to ensure a better quality of advice-giving and support to follow-up women at home.
Adult↗
Infant survival, HIV infection, and feeding alternatives in less-developed countries.
OBJECTIVES: This study examines, in the context of the human immunodeficiency virus (HIV) epidemic, the effects of optimal breast-feeding, complete avoidance of breast-feeding, and early cessation of breast-feeding. METHODS: The three categories of breast-feeding were weighed in terms of HIV transmission and infant mortality. Estimates of the frequency of adverse outcomes were obtained by simulation. RESULTS: Avoidance of all breast-feeding by the whole population always produces the worst outcome. The lowest frequency of adverse outcomes occurs if no HIV-seropositive women breast-feed and all seronegative women breast-feed optimally, given infant mortality rates below 100 per 1000 and relative risks of dying set at 2.5 for non-breast-fed compared with optimally breast-fed infants. For known HIV-seropositive mothers, fewer adverse outcomes result from early cessation than from prolonged breast-feeding if the hazard of HIV transmission through breast-feeding after 3 months is 7% or more, even at high mortality rates, given relative risks of dying set at 1.5 for early cessation compared with optimal duration of breast-feeding. CONCLUSIONS: The risk of HIV transmission through breast-feeding at various ages needs to be more precisely quantified. The grave issues that may accompany a possible decline in breast-feeding in the less developed world demand evaluation.
Adult↗
Parental experiences of feeding problems in their infants with Down syndrome.
Although feeding difficulties in infants with Down syndrome are described in the literature, the experiences of parents regarding the feeding problems of their infants are largely omitted. In order to promote closer collaboration with families and speech-language therapists in early communication intervention, the study investigated some experiences of a group of parents concerning the feeding problems of their infants with Down syndrome. A descriptive survey approach was implemented to collect quantitative data. The results revealed the type of feeding problems and associated conditions occurring in the infants of the twenty participants; the type of feeding methods used; the assistance received during the feeding problems; the emotions experienced in relation to the feeding problems in their infants as well as suggestions made by the participants regarding the management of early feeding problems. Numerous feeding problems occurred in the infants and the variety of emotions experienced by the participants indicated that feeding therapy and counseling were required. As a result of the different conditions underlying the feeding problems of the participants' infants, a comprehensive approach, which included therapeutic and medical intervention, was necessary. In order to provide effective early communication intervention services from birth, the results indicated that the knowledge, skills and sensitivity of speech language therapists to identify caregiver needs, to provide appropriate family-focused intervention and to make recommendations regarding the management of feeding problems in infants with Down syndrome is of great importance.
Affect↗